Development and psychometric validation of the fear of physical activity during pregnancy scale.

OBJECTIVE

To develop and evaluate the psychometric properties of the Fear of Physical Activity During Pregnancy Scale (FPAPS) among Chinese pregnant women.

DESIGN

A methodological study.

METHODS

The study was conducted in three phases. Phase I involved item generation informed by the fear-avoidance model, a literature review, and semi-structured interviews. Phase II refined the item pool through expert consultation and pilot testing. Phase III evaluated the scale in a cross-sectional sample of 507 pregnant women. The sample was divided into two non-overlapping subsamples for item analysis and exploratory factor analysis (n = 230) and confirmatory factor analysis (n = 277). Content validity, structural validity, hypotheses testing for construct validity, internal consistency, two-week test-retest reliability, and floor and ceiling effects were evaluated.

RESULTS

The final FPAPS comprised seven items and showed a unidimensional structure. Exploratory factor analysis explained 50.5% of the variance, and a revised confirmatory factor analysis model showed acceptable fit. The S-CVI/Ave for the final scale was 1.000. Average variance extracted was 0.578, composite reliability was 0.900, Cronbach's alpha was 0.863, McDonald's omega was 0.870, and the two-week test-retest intraclass correlation coefficient was 0.706. No floor or ceiling effects were observed. Higher FPAPS scores were associated with lower total physical activity, moderate-intensity activity, vigorous-intensity activity, moderate-to-vigorous physical activity, and exercise/sports activity. Women without pre-pregnancy physical activity habits and primiparous women reported higher FPAPS scores.

CONCLUSION

The FPAPS is a brief, pregnancy-specific scale with acceptable initial psychometric properties for assessing fear-related cognitions about physical activity during pregnancy among Chinese pregnant women.